| 1. |
- Bergkvist, Leif, et al.
(författare)
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Axillary recurrence rate after negative sentinel node biopsy in breast cancer : three-year follow-up of the Swedish Multicenter Cohort Study
- 2008
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Ingår i: Annals of Surgery. - : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 247:1, s. 150-156
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sentinel lymph node biopsy is an established staging method in early breast cancer. After a negative biopsy, most institutions will not perform a completion axillary dissection. The present study reports the current axillary recurrence (AR) rate, overall and disease-free survival in the Swedish Multicenter Cohort Study.Methods: From 3534 patients with primary breast cancer ≤3 cm prospectively enrolled in the Swedish multicenter cohort study, 2246 with a negative sentinel node biopsy and no further axillary surgery were selected. Follow-up consisted of annual clinical examination and mammography. Twenty-six hospitals and 131 surgeons contributed to patient accrual.Results: After a median follow-up time of 37 months (0-75), the axilla was the sole initial site of recurrence in 13 patients (13 of 2246, 0.6%). In another 7 patients, axillary relapse occurred after or concurrently with a local recurrence in the breast, and in a further 7 cases, it coincided with distant or extra-axillary lymphatic metastases. Thus, a total of 27 ARs were identified (27 of 2246, 1.2%). The overall 5-year survival was 91.6% and disease-free survival 92.1%.Conclusions: This is the first report from a national multicenter study that covers, not only highly specialized institutions but also small community hospitals with just a few procedures per year. Despite this heterogeneous background, the results lie well within the range of AR rates published internationally (0%-3.6%). The sentinel node biopsy procedure seems to be safe in a multicenter setting. Nevertheless, long-term follow-up data should be awaited before firm conclusions are drawn.
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| 2. |
- Mattsson, Jan, et al.
(författare)
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Sentinel node biopsy in malignant melanoma : Swedish experiences 1997-2005
- 2008
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Ingår i: Acta Oncologica. - : Informa Healthcare. - 0284-186X .- 1651-226X. ; 47:8, s. 1519-1525
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Tidskriftsartikel (refereegranskat)abstract
- The sentinel node biopsy (SNB) procedure is a multidisciplinary technique, invented to gain prognostic information in different malignant tumors. The aim of the present study was to study the cohort of patients with malignant melanoma, operated with SNB, from the introduction of the technique in Sweden, concerning the prognostic information retrieved and the outcome of the procedures. In Sweden all patients with malignant melanoma are registered at regional Oncological Centers. From these databases ten centers were identified, treating malignant melanoma and performing sentinel node biopsy. Consecutive data concerning tumor characteristics, outcome of the procedure and disease related events during the follow-up time were collected from these ten centers. All cases from the very first in each centre were included. The SNB procedure was performed in 422 patients with a sentinel node (SN) detection rate of 97%, the mean Breslow thickness of the primary tumors was 3.2 mm (median 2.4 mm) and the proportion of ulcerated melanomas 38%. Metastasis in the SN was found in 19% of the patients but there was a wide range in the proportion of SN metastases between the different centers (5-52%). After a follow-up of median 12 months of 361 patients, SN negative patients had better disease-free survival than SN positive (p<0.0001). A false negative rate of 14% was found during the follow-up time. In this study the surgical technique seemed acceptable, but the non-centralized pathology work-up sub-optimal. However, SNB was still found to be a significant prognostic indicator, concerning disease free survival.
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| 3. |
- Schüle, Jana, et al.
(författare)
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Sentinel node biopsy for breast cancer larger than 3 cm in diameter
- 2007
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 94:8, s. 948-951
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Tidskriftsartikel (refereegranskat)abstract
- Background:Sentinel node biopsy (SNB) is a standard staging procedure in early breast cancer. Its suitability for larger tumours has been questioned. This study evaluated the reliability of SNB in women with invasive breast cancer larger than 3 cm in diameter who were clinically axillary node negative.Methods:Some 109 women with a tumour larger than 3 cm on pathological analysis were identified from the Swedish prospective SNB database. They were included if a completion axillary clearance was planned, regardless of SNB results.Results:The sentinel node detection rate was 103 (94·5 per cent) of 109. The overall false-negative rate was eight (13 per cent) of 64. Although a preoperative diagnosis of multifocal tumour was an exclusion criterion, 16 such cases were revealed on postoperative pathological examination. The false-negative rate in this subgroup was higher than that in women with a unifocal tumour (four (31 per cent) of 13 versus four (8 per cent) of 51; P = 0·012). No other significant predictors of a false-negative sentinel node biopsy were identified.Conclusion:SNB is feasible in patients with unifocal breast tumours larger than 3 cm. When large tumour size coincides with multifocality, however, the false-negative rate seems to be increased and a completion axillary clearance should be considered even if the SNB is negative.
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